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CASE STUDY OF DMDiabetes mellitus

is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose

in the blood

cannot beabsorbed into the cells of the body. Symptoms include

frequent urination

, lethargy,excessive thirst, and hunger. The treatment includes changes in diet, oral medications,and in some cases, daily injections of insulin.The most common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this form of diabetes occurs most often in people who are overweightand who do not exercise. Type II is considered a milder form of diabetes because of itsslow onset (sometimes developing over the course of several years) and because itusually can be controlled with diet and oral medication. The consequences of uncontrolled and untreated

Type II diabetes

, however, are the just as serious as those for Type I. This form is also called noninsulin-dependent diabetes, a term that is somewhatmisleading. Many people with Type II diabetes can control the condition with diet andoral medications, however, insulin injections are sometimes necessary if treatment withdiet and oral medication is not working.The causes of diabetes mellitus are unclear, however, there seem to be both hereditary(genetic factors passed on in families) and environmental factors involved. Research hasshown that some people who develop diabetes have common genetic markers. In Type Idiabetes, the immune system, the body’s defense system against infection, is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin. In Type II diabetes, age, obesity, and family history of diabetes play arole.In Type II diabetes, the pancreas may produce enough insulin, however, cells have become resistant to the insulin produced and it may not work as effectively. Symptoms of Type II diabetes can begin so gradually that a person may not know that he or she has it.Early signs are lethargy, extreme thirst, and frequent urination. Other symptoms mayinclude sudden weight loss, slow wound healing,

urinary tract infections

, gum disease, or blurred vision. It is not unusual for Type II diabetes to be detected while a patient isseeing a doctor about another health concern that is actually being caused by the yetundiagnosed diabetes.Individuals who are at high risk of developing Type II diabetes mellitus include peoplewho:

•

are obese (more than 20% above their ideal body weight)

•

have a relative with diabetes mellitus

•

belong to a high-risk ethnic population (African-American, Native American,Hispanic, or Native Hawaiian)

•

have been diagnosed with gestational diabetes or have delivered a baby weighingmore than 9 lbs (4 kg)

•

have

high blood pressure

(140/90 mmHg or above)

•

have a high density lipoprotein cholesterol level less than or equal to 35 mg/dLand/or a triglyceride level greater than or equal to 250 mg/dL

•

have had

impaired glucose tolerance

or impaired fasting glucose on previous testingDiabetes mellitus is a common chronic disease requiring lifelong behavioral and lifestylechanges. It is best managed with a team approach to empower the client to successfullymanage the disease. As part of the team the, the nurse plans, organizes, and coordinatescare among the various health disciplines involved; provides care and education and promotes the client’s health and well being. Diabetes is a major public health worldwide.Its complications cause many devastating health problems.

ANATOMY AND PHYSIOLOGY:

Every cell in the human body needs energy in order to function. The body’s primaryenergy source is glucose, a simple sugar resulting from the digestion of foods containingcarbohydrates (sugars and starches). Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas, an organ located behind the stomach. Insulin bonds toa receptor site on the outside of cell and acts like a key to open a doorway into the cellthrough which glucose can enter. Some of the glucose can be converted to concentratedenergy sources like glycogen or fatty acids and saved for later use. When there is notenough insulin produced or when the doorway no longer recognizes the insulin key,glucose stays in the blood rather entering the cells.

PATHOPHYSIOLOGY:

Image Source:

www.caninsulin.com/Pathophysiology-algorithm.htmDIAGNOSTIC TEST:

Several blood tests are used to measure blood glucose levels, the primary test for diagnosing diabetes. Additional tests can determine the type of diabetes and its severity.

•

Random

blood glucose test

— for a random blood glucose test, blood can be drawnat any time throughout the day, regardless of when the person last ate. A random

blood glucose level

of 200 mg/dL (11.1 mmol/L) or higher in persons who have